Stopping the cycle of violence in St. Louis is the mission of a new consortium of four hospitals and two academic institutions, believed to be the first collective effort of its kind. (Photo: Joe Angeles/Washington University)

The Institute for Public Health at Washington University in St. Louis will launch the regional St. Louis Area Hospital-Based Violence Intervention Program (STL-HVIP), which will aim to promote positive alternatives to violence, thanks to a $1.6 million grant from Missouri Foundation for Health (MFH).

The program, a collaboration between Washington University in St. Louis, Saint Louis University, Barnes-Jewish Hospital, SSM Health Saint Louis University Hospital, St. Louis Children’s Hospital and SSM Health Cardinal Glennon Children’s Hospital, will form the only such partnership of hospitals and academic institutions in the nation.

The University of Missouri – St. Louis will also be involved in program evaluation discussions.

“This kind of program is a wonderful example of the power and impact of research universities and hospitals, working together to face head-on one of America’s greatest public health challenges,” said Washington University Chancellor Mark S. Wrighton. “Interrupting the cycle of violence in our region is crucial, and I am pleased that Washington University’s Institute for Public Health has stepped forward to help lead such an effort.”

“The STL-HVIP, which has been in the works for more than two years, will have a truly regional mission,” said William Powderly, MD, the J. William Campbell Professor of Medicine and the Larry J. Shapiro Director of the Institute for Public Health at Washington University in St. Louis.

“The model for this program is not new, however; to our knowledge, no other city has implemented the model across two different health systems and four different hospitals, in collaboration with two universities,” he said.

Washington University began convening local leaders in 2014 to address the issue of gun violence as a public health crisis, leading to the formation of the university’s Gun Violence Initiative. The idea for the initiative was sparked by Risa Zwerling Wrighton, Chancellor Wrighton’s wife, following the shooting death of her 16-year-old mentee Chelsea Harris.

The new program will promote alternatives to violence in order to reduce retaliation, criminal involvement, re-injury and death among individuals injured by gunshot, stabbing or assault.

This work aligns with the St. Louis Area Violence Prevention Commission’s effort to foster coordination among many stakeholders working on evidence-based violence prevention strategies. The program represents contribution from hospitals to the regional discussion and the commission’s goals.

“While this model may reduce medical system costs, the real focus is on reducing the toll on the community from productivity losses, diminished quality of life and toxic stress, reducing death and suffering, and bolstering healthy environments for individuals and families affected by violence,” said Victoria Anwuri, associate director of the Institute for Public Health.

Hospitals are well positioned to interrupt the cycle of violence by intervening at a uniquely teachable moment when individuals have survived a violent injury, she said.

“The program will serve victims of violence from the four Level 1 trauma and emergency centers in the St. Louis region that provide the majority of violent injury related care,” Anwuri said.

“Participants will be matched with clinical case managers who will deliver evidence-based interventions such as trauma-informed care, motivational interviewing and brief therapy,” she said. “Training, resource sharing and communication will be coordinated across all four sites by the Institute for Public Health. A repository of shared regional data will enable evaluation of the program’s primary objective — the reduction of recidivism for interpersonal violent injury — at the regional level.”

“St. Louis Children’s is pleased to expand its pilot program with youth victims of violence through this funding,” said Joan Magruder, president of St. Louis Children’s Hospital, which has been running a scaled-down version of the intervention. “We have seen how powerful intervention at a moment of crisis can be in changing the trajectory of lives. The MFH grant will enable us to test this intervention on a much larger scale, including both youth and adults — which we expect will have great impact on the community.”

“This program is truly unique and an outstanding opportunity for St. Louis’ academic medical centers to collaborate towards reducing violence in the region,” said Kate Becker, president of SSM Health Saint Louis University Hospital.

“Violence is a major factor that contributes to the many health disparities that affect the patients, families and communities we serve,” said Bob Cannon, president of Barnes-Jewish Hospital. “Through this unique partnership, we look forward to enhancing our efforts toward our goals of mitigating health disparities and achieving health equity.”

“We are proud to partner on a team effort to reduce the reoccurrence of violence for our community,” says Steven Burghart, president of SSM Health Cardinal Glennon Children’s Hospital. “Collaboration across providers is key to ensuring we can help as many children and families as possible.”

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